Active NPI
Priscilla Sioson-Aherrera, MD
- Infectious Disease Physician
- Jackson, TN
National Provider Identifier
1346275906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 19247
- Practice address
- 620 Skyline Dr
Jackson, TN 38301-3923 - Phone
- (731) 541-6472
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | 19247 | TN | Primary |
Addresses
Primary practice location
620 Skyline Dr
Jackson, TN 38301-3923
Mailing address
620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-6472
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3050460 | Medicaid | TN | |
| 3050461 | Medicaid | TN | |
| 440003621 | Other | RR MEDICARE | |
| 4055519 | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19247 | TN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infectious Disease Consultants of Jackson, PC | Infectious Disease | Current | Accepting new patients |
Locations
367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000
1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273
620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Infectious Disease Physician
- Jackson, TN
- NPI 1316029648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265673600000",
"number": "1346275906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 SKYLINE DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013923",
"telephone_number": "731-541-6472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 SKYLINE DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383013923",
"telephone_number": "731-541-6472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIOSON-AHERRERA",
"first_name": "PRISCILLA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2010-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "TN",
"license": "19247",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3050460",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3050461",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "440003621",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4055519",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.